Concurrent Enrollment Authorization

Concurrent Enrollment Authorization
Students: Please complete and submit this portion of the form. An international student program advisor will review your request. If approved we will send you the completed Concurrent Enrollment Authorization or contact you for more information if needed.

You may contact us at internationalprogram@sjcc.edu or 408-759-4499 with questions.
Name:*
SJCC ID#*
Email*
example@example.com
Term:*
Name of College I Plan to Attend:*
Class(es) I Plan to Enroll:*
Reason for Seeking Enrollment at Another College:*
The class(es) listed above are being used to meet my 12-unit course requirement, I understand that it is my responsibility to provide verification of concurrent enrollment to San Jose City College within 20 days of the start of classes.
Student Signature:*

Clear
Date:*

MonthDayYear
Date
To Be Completed by the Designated School Official (DSO)
This is to certify that the student named above is an international student currently enrolled at San Jose City College. S/he is in valid F-1 status and is in good academic standing. Please allow her/him to enroll at your college. Please feel free to contact me if you have any additional questions.
Name & Title of DSO
Signature of DSO

Clear
Date

MonthDayYear
Date
Should be Empty: